Can a Car Insurance Company Refuse to Pay a Claim?

Not only is purchasing car insurance a legal requirement, but it can also prevent a motorist from incurring costly expenses associated with traffic accidents and provide a financial barrier if they are found liable for an accident. However, no car insurance provider is perfect, and many motorists know from first-hand experience the stress caused by an insurance carrier that has denied a claim. At John Foy & Associates, an Atlanta denied car insurance claim lawyer can help you with the claims process.

Car Insurance Requirements in Georgia

Like most states, Georgia law requires all motorists to purchase car insurance to operate a motor vehicle in the state lawfully. According to the Georgia Office of Commissioner of Insurance and Safety Fire, Georgia drivers must maintain a minimum liability coverage limit:

• $25,000 per person and $50,000 per incident for bodily injury sustained during an accident. 
• $25,000 per incident for property damage sustained during an accident. 

Further, Georgia state law does not require motorists to purchase physical damage coverage. However, this coverage can cover total damage, including theft, vandalism, bad weather, or fire-related issues (comprehensive coverage). Alternatively, a motorist can purchase a policy that only covers damage caused during an accident (collision coverage). 

Lastly, Georgia requires all motorists to maintain minimum liability coverage. Thus, operating a motor vehicle without it is against the law. Nonetheless, drivers still use motor vehicles without coverage and end up in accidents. 

Uninsured Insurance Coverage

Georgia does not require drivers to purchase “uninsured” or “underinsured” coverage, which pays for costs associated with another driver’s liability without another insurance company assisting with costs. This type of insurance coverage could come in handy if a driver were to ever get into a car accident with an uninsured/underinsured driver. 

Every motorist should understand the severity of many Atlanta car accidents and the importance of obtaining the right insurance policy.  

Why Insurance Companies Deny Claims

Like mst commercial enterprises, insurance companies sell products designed to meet a consumer’s need to generate a profit for their shareholders. Insurance companies employ teams of adjustors, analysts, and attorneys to review claims and determine whether the policyholder’s insurance claim is covered under their existing policy. 

In some instances, an insurance company may be justified in its denial of a claim. In others, they are not. Below is a summary of the cases when an insurance company denies a claim. 

The Driver Has Reached Their Policy Limit

When purchasing automotive insurance, virtually all insurance companies cap the amount of coverage they will provide drivers under a policy. They will ensure that their policies meet Georgia standards for coverage, and they often offer additional coverage options beyond the statutory limit. However, if a driver experiences enough accidents or reaches that limit, the company may deny the claim or reduce the claim amount. 

Limitation on Policy Coverage 

Not every automotive insurance policy is the same. For example, some drivers purchase policies that provide the statutory minimum because Georgia does not require comprehensive or collision coverage. Thus, if a driver with minimal insurance has their car vandalized, their insurance carrier will likely not cover the cost of damages. 

The Driver Committed an Unlawful Act 

Insurance companies may deny claims to drivers that have broken a law that caused the accident. For example, insurance companies often deny claims of drivers operating their vehicles under the influence of drugs or alcohol. Drivers should be aware of the impact a drunk driving accident can have on themselves and their loved ones. 

Failing to Report an Accident 

An insurance provider may deny a driver’s claim that failed to report an accident or injuries related to an accident. Insurance companies require their policyholders to contact them within a specific time period after an accident. This allows the provider to be put on notice and for the claims process effectively address damages. 

Insurance companies want to prevent suspicious claims of damages or injuries from being submitted long after an accident. However, some injuries or damage can manifest days or weeks after a claim has been processed, which creates issues for policyholders seeking compensation for additional issues. 

Providing False Information

An insurance company will only accept a car insurance claim if they discover the policyholder has been truthful during the claims process. This prevents theft and fraud. However, in many instances, policyholders do not intentionally withhold information or misrepresent facts. 

This often occurs when a policyholder needs to fully understand all the facts or be provided proper instruction to address their claim.

Appealing the Denial of an Insurance Claim

Once an insurance provider has denied a claim, a policyholder may appeal that denial under the company’s claims appeal process. Through this process, policyholders can present additional facts and arguments as to why the denial of their claim was inappropriate. 

Follow the Appeal Process 

Most insurance providers had instituted a formalized claims process. This allows policyholders with denied claims to address the claim’s issues with a formalized review. Most appeals require the submission of additional documentation like police reports, witness statements, mechanic receipts, and medical bills. 

An appeals process usually allows the policyholder to draft a letter in support of appealing the original denial. It is best to seek counsel from an experienced Georgia insurance denial claims attorney to assist in the appeal process. 

Consider Filing a Lawsuit

If an appeal to overturn a claim denial is also denied, the policyholder should consider filing a lawsuit against the company. Even if the policyholder’s case for a full claim payment is inappropriate, insurance companies will often provide some coverage options given the circumstances. Filing a lawsuit may be the policyholder’s only option to ensure some coverage of their claim is provided. 

Furthermore, under O.C.G.A. §33-4-6, filing a lawsuit if the insurance company acted in bad faith may entitle the policyholder to damages and attorneys fees under the right circumstances. Damages include up to 50% of the underlying claim’s worth or $5,000, whichever is greater. 

Contact a Car Insurance Claim Denial Attorney

John Foy & Associates provides quality legal services to those that have been denied insurance claims for recent accidents. To learn more or request a free consultation, please get in touch with us today.